Liver Cancer: Obesity-related liver cancer cases to rise over 10% by 2050; Here's how to prevent it

The latest health warning regarding liver cancer has arrived with grim news and a hopeful silver lining.According to data published in the Lancet Commission on Liver Cancer, the number of new liver cancer cases is expected to increase from 870,000 in 2022 to 1.52 million in 2050, with obesity being the key contributing factor behind the surge.

At the same time, deaths from liver cancer are set to rise from 760,000 to 1.37 million, making it one of the fastest-growing causes of cancer-related death worldwide.That’s the alarming backdrop behind the growing toll of obesity-related liver cancer, especially metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as NAFLD.However, the same study has also revealed that at least 60% of liver cancers could be preventable: lifestyle changes, vaccination, early detection, and public policy could avert up to 17 million cases and save 15 million lives by mid-century.

Obesity’s role in liver cancer: What does the study say

The recent Lancet Commission report highlights MASLD, fatty liver linked to metabolic dysfunction, as a rapidly growing cause of liver cancer. The share of cases tied to MASLD (specifically MASH, the inflammatory form) is projected to rise from 8% in 2022 to 11% by 2050.Earlier meta-analyses show that higher BMI significantly increases liver cancer risk, with hazard ratios up to 3.1 in people with obesity versus healthy weight.

In fact, years of data reveal that in men and women, roughly 28% of liver cancer cases are attributable to excess weight.DALYs (disability-adjusted life years) tied to high BMI surged globally from 292,700 in 1990 to over 1.2 million by 2021, a nearly 323% increase. The trend, as per research, is particularly steep in middle and low-middle social development index regions, where metabolic risk factors are accelerating faster than public health responses.

The projected rise: What the numbers warn us

The Lancet Commission projects nearly 1.52 million liver cancer cases by 2050, with deaths increasing from about 760,000 in 2022 to 1.37 million.Another major modeling study, published in Nature last year, put new cases at around 1.39 million by 2040, a 54% rise from 2020 levels.This rise is being propelled by avoidable risk factors: obesity, alcohol use, and viral hepatitis. While hepatitis-related cases are expected to decline slightly, obesity-linked liver cancers are on the rise across the U.S.,

Europe, and Asia.

What is liver cancer?

Liver cancer is a disease where malignant (cancerous) cells develop in the liver. It can be either primary liver cancer, which originates in the liver, or secondary liver cancer, which spreads to the liver from another part of the body. The most common type of primary liver cancer in adults is hepatocellular carcinoma (HCC).There are several types of liver cancer:Primary liver cancer:Hepatocellular Carcinoma (HCC): The most common type, originating in hepatocytes (main liver cells). Intrahepatic Cholangiocarcinoma: Develops in the bile ducts within the liver. Angiosarcoma/Hemangiosarcoma: Rare, fast-growing cancers originating in the liver's blood vessels. Hepatoblastoma: A rare type primarily affecting children. Secondary liver cancer: Cancers that spread to the liver from other organs, like the colon, lung, or breast.

Risk factors:

Several risk factors can increase the likelihood of developing liver cancer.

These include chronic hepatitis B and C infections, heavy alcohol consumption, obesity, and exposure to certain chemicals like aflatoxins. Additionally, conditions like cirrhosis, inherited liver diseases, diabetes, and non-alcoholic fatty liver disease can also elevate the risk.Lifestyle factors like heavy alcohol consumption and smoking are associated with a higher risk of liver cancer, often leading to cirrhosis and potentially causing HCC. Besides, obesity and non-alcoholic fatty liver disease (NAFLD), where fat accumulates in the liver without excessive alcohol use, are also linked to increased liver cancer risk.

Why is liver cancer so deadly?

Liver cancer is often deadly due to a combination of factors, including late-stage diagnosis, limited treatment options, and the liver's vital role in the body. Many cases are discovered after the cancer has already spread, and the liver's complex function makes treatment challenging.Moreover, liver cancer is highly aggressive, especially once MASLD progresses to MASH (steatohepatitis) and then cirrhosis or carcinoma, and there are only limited treatment options for liver cancer, with 5-year survival rates generally under 30%. As per research, three in five liver cancer cases are linked to preventable risk factors, and global prevention strategies could reduce incidence rates annually by 2–5%, averting millions of cases and deaths.

Experts’ take

Professor Jian Zhou of Fudan University, who chaired the study, emphasized the need for global action. “Liver cancer is one of the most challenging cancers to treat, with five-year survival rates ranging from just 5% to 30%. Without urgent action, we risk seeing a near-doubling of cases and deaths in just 25 years,” he told NBC News.Professor Stephen Chan from the Chinese University of Hong Kong, lead author of the study, echoed this sentiment, saying, “Three in five liver cancer cases are caused by preventable risk factors, mainly viral hepatitis, alcohol, and obesity.

This presents a huge opportunity to intervene, save lives, and reduce healthcare burdens worldwide.”

Prevention: Lifestyle choices that could make a difference

Despite the concerning projected rise, one of the most highlighted findings from the Commission: 60% of liver cancer cases are preventable. Small steps go a long way and pave the path for liver cancer prevention.Maintain a healthy weight and active lifestyle: Adopt a diet rich in fruits, vegetables, whole grains, lean protein, and healthy fats, as recommended by the World Cancer Research Fund.

Regular physical activity, as little as 30 minutes a day, can help manage weight, reduce inflammation, and improve liver health.Screening and early detection: Individuals with obesity, diabetes, hypertension, or elevated liver enzymes should get regular check-ups. Early detection of MASLD or MASH enables intervention before progression to cancer.Vaccination against Hepatitis B (and HCV management): Universal HBV vaccination, especially at birth, has dramatically reduced virus-linked liver cancer.

While no HCV vaccine is available yet, antiviral treatments significantly lower the risk for infected individuals.Limit alcohol and sugary drink intake: Alcohol is a known carcinogen tied to about 19% of global liver cancer deaths; excess sugars and processed foods fuel obesity and fatty liver, both risk multipliers.Weight loss interventions for high BMI: For individuals with Class II obesity or metabolic syndrome, interventions from dietary change to bariatric surgery may reduce MASLD and liver cancer risk. Surgery has shown about 92% resolution of steatosis in many cases.